Marjon Borgert

27 Standardized measurement of the Modified Early Warning Score ‘Retrospectively calculated MEWS’ represent the MEWS calculated by the researchers based on the actual set (irrespective of completeness) of vital signs measured. ‘Complete set of measurements’ relates to the measurement of eight MEWS parameters and the MEWS summary score. Cardiopulmonary arrest was de ned as an event in which respiratory and/or cardiopulmonary activity was absent and for which the cardiopulmonary arrest team was called and initiated cardiopulmonary resuscitation which included pharmacological, uid, or mechanical resuscitation. 23 An unplanned ICU admission was de ned as an admission that could not have been deferred without risk for at least 12 hours. 24 APACHE IV (Acute Physiology and Chronic Health Evaluation) scores indicate illness severity for those admitted to the ICU, whereby higher scores correspond to more severe disease and higher risks of death. 25 Eurse Calculate the MEWS according to protocol Eurse Patient with MEWS < 3 Eurse Patient with MEWS ≥ 3 Follow local guidelines Eurse Call the physician immediately. Use the SBAR technique PŚLJsician͗ ф ϯϬ ŵinutes Assess the patient and draft medical policy Eurse If physician does not comply with guideline and time limits: always and directly activate the RRT PŚLJsician͗ aĨter assessŵent oĨ Ɖatient Option to directly activate RRT PŚLJsician͗ ф ϲϬ ŵinutes Determine therapy effect PŚLJsician͗ /n case no eĨĨect oĨ tŚeraƉLJ Always and directly activate the RRT Figure 1. Algorithm for RRT activation which displays the protocol of handling critical MEWS values including all subsequent actions which either nurse or physician has to undertake together with set time limits.